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Improving physician handover documentation process for patient transfer from paediatric intensive care unit to
Hamza Alali1,2, Mohannad Antar3,2, Ali AlShehri3,2,4
1Pediatrics, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia drhamza80@hotmail.com.
Insights
Standardizing patient handover documentation from the pediatric intensive care unit (PICU) to general wards significantly improved physician compliance and satisfaction. This quality improvement initiative also reduced emergency readmissions from the PICU within 48 hours.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety
- Clinical Communication
Background:
- Inadequate handover communication during patient transfer is a major cause of adverse events.
- Contributing factors include incomplete or non-standardized documentation processes.
- This study focuses on improving handover documentation from the pediatric intensive care unit (PICU) to general pediatric wards.
Purpose of the Study:
- To standardize the handover documentation process for patients transferring from the PICU to general pediatric wards.
- To address deficiencies in handover communication and documentation quality.
- To enhance patient safety and care continuity.
Main Methods:
- A quality improvement project was implemented to address issues identified through data analysis and team brainstorming.
- Interventions included the development of a standardized handover form and educational sessions for healthcare professionals.
- Key quality measures assessed physician compliance, physician satisfaction, and PICU emergency readmission rates within 48 hours.
Main Results:
- Physician compliance with handover documentation elements increased from 29.5% to 95.5%.
- Physician satisfaction with communicated information during handover improved from 47.5% to 84%.
- The PICU emergency readmission rate within 48 hours decreased from 3.8% to zero.
Conclusions:
- Implementing a standardized handover form is crucial for improving documentation clarity and reducing data omission.
- Effective handover documentation positively impacts physician satisfaction in managing post-PICU patients.
- Standardized processes enhance patient safety and care transitions from critical care settings.
Background:
Inadequate handover communication is responsible for many adverse events during the transfer of care, which can be attributed to many factors, including incomplete documentation or lack of standardised documentation process. The quality improvement project aimed to standardise the handover documentation process during patient transfer from paediatric intensive care unit (PICU) to the general paediatric ward.
Methods:
Data analysis revealed lack of proper handover documentation with the omission of vital information when transferring patients from PICU to general ward. The quality improvement team assessed the current handover documentation practice using a brainstorming technique during multiple meetings. The team evaluated the process for possible causes of incomplete handover documentation, framed the existing challenges, and proposed improvement interventions, including a standardised handover form and conducting education sessions for the new proposed process. The main quality measures included physician's compliance with handover documentation elements, physician's satisfaction and PICU emergency readmission rate within 48 hours.
Results:
Physician compliance to handover documentation improved from 29.5% to 95.5% before and after implanting the improvement interventions, respectively. The level of physician satisfaction with the quality of communicated information during the handover process improved from 47.5% to 84%, and the PICU emergency readmission rate declined from 3.8% to zero after all improvement interventions were implanted.
Conclusion:
Implementation of standardised handover form is essential to improve physician compliance for clear handover documentation and to avoid data omission during the patient transfer process. Documented handover in patient's medical record has positive impact on physician satisfaction when managing patients recently discharged from PICU.
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